Department of Medicine, Division of Rheumatology, University of California, San Francisco, California, USA.
University of Queensland Faculty of Medicine.
Curr Opin Rheumatol. 2020 Sep;32(5):434-440. doi: 10.1097/BOR.0000000000000725.
The novel coronavirus 2019 (COVID-19) pandemic is of special concern for patients with immune-mediated inflammatory disease (IMID) and those who care for them because of the potential for worse outcomes. This article analyzes peer-reviewed research on the epidemiology and outcomes of COVID-19 in those with IMID.
Published literature on approximately 1400 patients was included from rheumatology, gastroenterology, and dermatology. Data suggest that those who are older and have comorbidities have poorer outcomes. This is consistent with the reports from the general population of patients with COVID-19. Adjusted analyses from the largest published studies demonstrate independent effects of systemic glucocorticoids, as well as age and comorbidities with poorer COVID-19 outcomes (SECURE-IBD registry, n = 525; COVID-19 Global Rheumatology Alliance registry, n = 600); biologic or targeted synthetic disease-modifying antirheumatic drug therapy has not been associated with more severe outcomes. These early results will require validation in population-based studies as more data becomes available.
Current data suggest that similar to the general population, age, and comorbidities are risk factors for poorer COVID-19 outcomes in patients with IMID. Additional research is needed to quantify outcomes and risk across rheumatic disease types, comorbidities, and immunosuppressive drugs.
新型冠状病毒 2019(COVID-19)大流行对患有免疫介导的炎症性疾病(IMID)的患者及其护理人员特别关注,因为他们可能会出现更差的结果。本文分析了关于 IMID 患者 COVID-19 的流行病学和结果的同行评议研究。
从风湿病学、胃肠病学和皮肤病学中纳入了约 1400 名患者的已发表文献。数据表明,年龄较大和合并症的患者预后较差。这与 COVID-19 患者一般人群的报告一致。来自最大的已发表研究的调整分析表明,全身糖皮质激素以及年龄和合并症与 COVID-19 结局较差独立相关(SECURE-IBD 登记处,n=525;COVID-19 全球风湿病联盟登记处,n=600);生物制剂或靶向合成疾病修饰抗风湿药物治疗与更严重的结局无关。随着更多数据的出现,这些早期结果需要在基于人群的研究中进行验证。
目前的数据表明,与一般人群相似,年龄和合并症是 IMID 患者 COVID-19 结局较差的危险因素。需要进一步研究来量化各种风湿病类型、合并症和免疫抑制药物的结局和风险。